Process and article for the treatment of severe epistaxis



J 7, 1969 s. o. FORITAY 3,420,231

PROCESS AND ARTICLE FOR THE TREATMENT OF SEVERE EPISTAXIS Filed Sept. 2,1966 i 5 l f INVENTOR STEVEN A. FORTAY ATTORNEYS United States PatentOfiflce 3,420,237 Patented Jan. 7, 1969 3,420,237 PROCESS AND ARTICLEFOR THE TREATMENT OF SEVERE EPISTAXIS Steven 0. Fortay, Woodbridge,N.J.; Martha K. Fortay,

executrix of the estate of said Steven 0. Fortay, (leceased; assignor toMartha K. Fortay (widow of Steven 0. Fortay), Woodbridge Township, NJ.

Filed Sept. 2, 1966, Ser. No. 576,944

U.S. Cl. 128325 Int. Cl. A61h 17/12 The present invention relates to anovel article and process for the treatment of severe nosebleed, i.e.,severe epistaxis, and, more particularly, to a method and article fortreating such severe epistaxis which employs a thin tape of rubberizedmaterial surrounded by a sleeve of gauze.

More than a century ago, a method of treating severe nosebleed byposterior packing was introduced. This method of packing the posteriorchamber of the nasal passage has many shortcomings, however. First ofall, it is a quite involved and delicate process to manipulate themedical packing material into the posterior chamber of the nasalpassages in order to adequately pack this posterior region to supplyadequate pressure so as to relieve and eliminate the problem of a severenosebleed. Furthermore, the packing of the posterior chamber of thenasal passage is fraught with the disadvantage that the packing materialeasily slips from its intended area, blocking the larynx and throatopening of the patient.

In addition, postnasal packs are often applied improperly. When soapplied, they may cause edema and pain, or their effects may be evenmore serious, such as osteomyelitis of the base of the sphenoid, earinfection, and so much edema that tracheostomy is necessary. Othercomplications include hemotympanurn, with or without otitis media, andlacerations of the soft palate and floor of the nose.

Although there have been various attempts made and ideas suggested for amethod to employ as a quick and practical alternative to conventionalposterior packing none of these have been satisfactorily adapted for thetreatment of severe epistaxis. Such concepts involve both physical andchemical approaches to this problem. Such alternative procedures usuallyinvolve the employment of complicated equipment and/ or processes inwhich a great deal of assistance is necessary to treat the severenosebleed. Note U.S. Patent 2,647,515. Thus, until the presentinvention, there has not been provided a simple and practicalalternative to the treatment of severe nosebleed by posterior packing.By the present invention, however, it has now been found possible totreat a severe epistaxis in a simple and practical manner without theuse of complicated devices and without the necessity for assistants. Ithas now been found possible to treat severe nosebleed by the use of athin tape of rubberized material having a sleeve of gauze-like materialsurrounding such tape, which tape and surrounding sleeve form a firmwall across the posterior chamber of the nasal passage.

This is accomplished by drawing such tape and surrounding armored sleevethrough the nasal passages by the use of a conventional nasal catheter.

It is, therefore, a principal object of the present invention to providean article for the treatment of severe nosebleed which is free from theinherent deficiencies of previously-employed materials and techniques.

A further object of the present invention is to provide a process forthe treatment of severe epistaxis which is easily and practicallyperformed, and which eliminates the inherent deficiencies anddisadvantages of prior known proceses, especially conventional posteriorpacking.

A still further object of the present invention is to provide an articlewhich comprises a thin, flexible tape of Claims rubberized materialsurrounded by a sleeve of gamelike material, which article can beemployed to easily and practically treat severe epistaxis by the processof the present invention.

A yet further object of the present invention is to provide such aprocess for the treatment of severe epistaxis wherein a thin, flexible,rubberized tape surrounded by a sleeve of gauze-like material is drawnthrough the nasal passages to form a firm wall across the posteriorchamber and to provide packing of the nasal passages.

Still further objects and advantages of the process and article of thepresent invention will become more apparent from the following moredetailed description of the present invention and the accompanyingdrawing, wherem:

FIGURE 1 is a view in elevation showing the tape of the presentinvention.

FIGU-R-ES 2 to 7 are frontal views pictorially showing various stages ofthe process of the present invention.

In the various figures, like numerals represent like elements.

As can be seen from FIGURE 1, the armored tape of the present invention,which is employed in the treatment of severe epistaxis, comprises, incombination, two parts. The inner portion or tape 2 comprises a thin,flexible, rubberized material. This can be either a natural or asynthetic rubber, or a flexible plastic material (i.e., polyethylene,etc.), or a fabric matrix which is impregnated with a natural orsynthetic rubber or plastic. The only essential characteristic of suchmaterial is that it be sufficiently flexible so as to be able to conformitself to the contour of the nasal passage and have suflicient densityso as to form a firm Wall across the posterior chamber of the nasalpassages so as to prevent the how of blood.

Ordinarily, the rubberized tape 2 is in the order of one-half inch toone inch in width, although narrower or wider strips can beadvantageously employed where desired, or necessary for particularpatients, or appropriate medical situations.

Surrounding the tape 2 of the article of the present invention, is asleeve 4 of gauze-like material. Such gauzelike material of the sleeve 4surrounding the tape 2 can be any conventionally-employed gauze-likematerial used for medical purposes. Exemplary are the cotton and gauzematerials. This gauze-like material should be soft and non-irritating tothe walls of the nasal passages.

In addition to allowing the tape 2 to form a more firm wall across theposterior chamber of the nasal passages, the sleeve 4 of gauze-likematerial additionally can act as a carrier for a hemostatic medicament,etc. Therefore, the gauze-like sleeve 4 may be impregnated or coatedwith a suitable antibiotic ointment, hemostatic medicament, astringent,etc. Exemplary materials include commercial preparations of penicillin,streptomycin, aureomycin, terramycin, thrombin, fibrinogen, epinephrine,etc.

FIGURE 2 shows the insertion of the tape and sleeve of the presentinvention in the nasal passages. Thus, a conventional nasal catheter 6is utilized to draw the rubberized tape-gauze-like sleeve assemblagethrough the mouth and down through the nostrils of the patient, thecatheter having been inserted through the nostrils of the patient.

The treatment is started by first cleaning the nose of the patient andapplying an aneestetic, if necessary. A rubber or plastic catheter 6with a slit near its tip is passed through the nasal chamber and graspedas it appears in the pharynx. The rubberized tape and surrounding sleeveis now inserted and passed through the slit in the catheter.

3 This point in the process of the present inevntion is shown in FIGURE2.

The catheter is then pulled back through the nasal passage leaving thetape and surrounding sleeve in place extending about eight inches fromthe nostril. The rubber or plastic catheter 6 is then inserted throughthe second notril in a similar manner. The other end of the tape andsurrounding sleeve is thereafter inserted into the catheter as shown inFIGURE 3, and the catheter is again pulled back through the nasalpassage with the attached tape and surrounding sleeve. The tape andsurrounding sleeve, when removed from the catheter, now has an endextending from each nostril of the patient. This position is representedin FIGURE 4. At this point, the tape and surrounding sleeve form a firmwall across the posterior chamber of the nasal passages.

Advantageously, the two ends of the tape and surrounding sleeve whichextend from the nostrils of the patient are now anchored with forceps 8,as illustrated in FIG- URES 5 and 6. The packing of the nostrils of thepatient may then proceed by pushing back the gauze from the tape littleby little i.e., in increments, as shown in FIG- URE 6 by use of aconventional packing instrument 10.

Optionally, after packing of the nasal passages by use of the sleeve ofgauze-like material, additional packing material may be utilized. Suchadditional packing can comprise any suitable medical packing materialconventionally used for packing of wounds. In most instances, however,the gauze-like sleeve acts as sufiicient packing material.

It is of note that because of the firm wall formed across the posteriorchamber of the nasal passages by the tape and surrounding sleeve of thepresent invention, there is no fear of the packing material beinginserted too far into the nasal cavity to cause blockage of the throatarea.

Also, ease of removal of additional packing material is a distinctadvantage of the process of the present invention since the tape andgauze-like sleeve acts as a barrier to the insertion of additionalpacking material to such a point at which its removal can no longer beaccomplished with case. When both chambers are packaged, a gauze pad maybe advantageously inserted in place in front of the nasal septum to actas a base for the subsequent tying of the ends of the tape andsurrounding sleeve.

The ends of the tape and surrounding sleeve are tied across the pad infront of the nasal septum. At this point, the treatment is completed.This last step, or position, is shown in FIGURE 7.

As stated previously, the employment of the sleeve of gauze materialsurrounding the rubberized tape, serves a dual function-that of allowingthe production of a more firm wall across the posterior chamber of thenasal passages, and that of simultaneously supplying antibiotic,hemostatic medicament, or astringent, to the treatment area.

It has been unexpectedly found that the use of a gauze sleeve inconjunction with the rubberized tape produces results far superior tothose that could be achieved by the use of a rubberize dtape alone. Inthis connection, it has been found that the use of a rubberized tapealone in many instances does not satisfactorily form a firm wall acrossthe posterior chamber of the nasal passages in that such material tendsto slip and move from its intended point. In addition, employment of thegauze-like sleeve eliminates any possibility of irritation to the nasalpassages which can be encountered by the use of a rubberized tape byitself.

While the present invention has beenprimarily described with respect tothe treatment of severe epistaxis, that is, a severe nosebleed, itshould be understood that this invention can be advantageously employedwhenever nasal packing is required. Thus, the process and article of thepresent invention, with their accompanying advantages, can be utilizedin packing of the nasal passages in case of nasal fractures, etc.

While a preferred embodiment of the present invention has beenillustrated, it is to be understood that the present invention is in noway to be deemed as limited thereto, but should be construed as broadlyas all equivalents thereof.

I claim:

1. An article for the treatment of severe epistaxis which comprises aflexible thin tape of rubberized material surrounded by a sleeve ofgauze-like material.

2. The article of claim 1 wherein said sleeve of gauzelike material iscoated or impregnated with antibiotic ointment or a hemostaticmedicament.

3. The article of claim 1 wherein said rubberized material is selectedfrom natural and synthetic rubbers, plastics, and cloth matricesimpregnated with such materials.

4. A method of treating severe epistaxis which comprises (1) inserting aflexible thin tape of rubberized material surrounded by a sleeve ofgauze-like material through the nasal passages by means of a nasalcatheter, said tape and sleeve, after insertion, having an end thereofextending from each nostril, said tape and surrounding sleeve forming afirm wall across the posterior chamber of the nasal passages, (2)packing the nostrils by feeding in gauze in increments, and (3) closingoff the nostrils by means of the ends of said tape and surroundingsleeve extending therefrom.

5. The method of claim 4 wherein a pad of gauze-like material is placedin front of the nasal septum as a base prior to scaling off the nostrilsby the ends of the tape and surrounding sleeve extending therefrom.

6. The method of claim 4 wherein the sleeve of gauzelike material iscoated or impregnated with an antibiotic ointment or hemostaticmedicament.

7. The method of claim 4 wherein the rubberized material is selectedfrom natural and synthetic rubber, plastics, and cloth matricesimpregnated with such materials.

8. The method of claim 4 wherein the ends of the tape and surroundingsleeve are held with forceps to create an anchor after insertion of thetape and sleeve and prior to packing to facilitate packing of the nasalpassages and to create a firm wall across the posterior chamber of thenasal passages.

9. The method of claim 8 wherein the sleeve of gauzelike material iscoated or impregnated with an antibiotic ointment or hemostaticmedicament.

10. The method of claim 8 wherein the rubberized material is selectedfrom natural and synthetic rubber, plastics, and cloth matricesimpregnated with such materials.

References Cited UNITED STATES PATENTS 2,007,503 7/1935 Riordan 128-2962,154,968 4/1939 Alkio 128348 2,524,195 10/1950 Hoover 128325 2,647,5158/1953 Pollock et al. 128-325 2,847,997 8/1958 Tibone 128325 3,049,1258/1962 Kriwkowitsch 128325 CHARLES F. ROSENBAUM, Primary Examiner.

1. AN ARTICLE FOR THE TREATMENT OF SEVERE EPISTAXIS WHICH COMPRISES AFLEXIBLE THIN TAPE OF RUBBERIZED MATERIAL SURROUNDED BY A SLEEVE OFGAUZE-LIKE MATERIAL.
 4. A METHOD OF TREATING SEVERE EPISTAXIS WHICHCOMPRISES (1) INSERTING A FLEXIBLE THIN TAPE OF RUBBERIZED MATERIALSURROUNDED BY SLEEVE OF GAUZE-LIKE MATERIAL THROUGH THE NASAL PASSAGESBY MEANS OF A NASAL CATHETER, SAID TABE AND SLEEVE, AFTER INSERTION,HAVING AND END THEREOF EXTENDING FROM EACH NOSTRIL, SAID TAPE ANDSURROUNDING SLEEVE FORMING A FIRM WALL ACROSS THE POSTERIOR CHAMBER OFTHE NASAL PASSAGES, (2) PACKING THE NOSTRILS BY FEEDING IN GAUZE ININCREMENTS, AND (3) CLOSING OFF THE NOSTRILS BY MEANS OF THE ENDS OFSAID TAPE AND SURROUNDING SLEEVE EXTENDING THEREFROM.